When It All Goes Downhill on the Slopes

An avalanche of winter-sports injuries leaves a tiny ER snowed under on weekends with skiers and boarders.

BIG BEAR — His first run of the day on the half-pipe "didn't work out," says Phil Whitman, stating the obvious with a painful smile, a tattered gauze sling supporting his arm.

Still wearing his snow boots and bib overalls, the 14-year-old is walking away from the emergency room at Bear Valley Community Hospital--an early end to the snowboarding weekend he had planned with his San Clemente church group. "They say I may have a broken humerus bone, but there's a three-hour wait," he says, figuring he'll try to find another, shorter-line hospital.

Second only to Catalina Island's facility as the smallest hospital in California, Bear Valley Community is stretched to the limit as the population of this San Bernardino County resort area soars from 18,000 to 100,000 on a typical winter weekend.

With a single physician and two registered nurses treating as many as 90 patients in a 24-hour period, the seven-bed emergency room becomes a Friday-through-Sunday-long episode of "Downhill ER," where injury meets the mountain after every run gone bad.

It's the part everyone prefers not to think about. After all, this is where people come for a taste of the great outdoors--of sunshine and snow, of downhill speed and beautiful vistas.

Big Bear, in the San Bernardino National Forest about 110 miles east of Los Angeles and 90 miles northeast of Orange County, is a popular destination for Southern California skiers and snowboarders. Snow Summit and Bear Mountain resorts are just two miles apart and within the service area of Big Bear City Fire Department and Bear Valley Community Hospital.

"It looks like Beirut in there," a woman says one Saturday of the hospital lobby, a small room with folding chairs, overflowing before noon with scores of banged-up but surprisingly patient patients.

"They're doing their best," says Jane Morris, 26, of Rancho Cucamonga, who hadn't heard anything since her husband, Robert, was brought in by ambulance an hour earlier from Snow Summit after slamming into a tree on his snowboard. "But this is the only place up here. How do they handle all these people?"

This is not a specialty trauma center but a small-town ER. Those with the mountain's most common hard knocks--broken wrists, blown-out knees, cuts and contusions--receive emergency treatment here. So do those hurt in traffic accidents and suffering heart attacks brought on by the 7,000-foot altitude. Those with the most serious injuries are typically airlifted from adjacent Big Bear Airport to Loma Linda University Medical Center in Redlands or Arrowhead Regional Hospital in San Bernardino.

Bear Valley Community is only half a mile from Snow Summit, a little more than that from Bear Mountain. So by ambulance, by car or simply limping in on their own, the ailing come here. When the hospital is in a state of injury overload, necessity is the mother of invention.

"We set up army cots in the ER ... we do our job," says registered nurse Dawn Macey, squinting at the late morning sun before returning to her 12-hour shift. "Sure, a bigger ER would help," she says. "But for now we're just here, giving great care with what we have."

Rick Rolston, Big Bear City Fire Division chief of emergency medical services, says all involved have learned to juggle the available resources. "We always have places to put them, but at certain times it gets very busy and very challenging," he says.

Meanwhile, he says, a three-year plan is in the works to expand the hospital.

Big Bear is not alone among ski areas seeing increased pressure on medical facilities. Last winter marked a record 57.3 million visits to U.S. ski resorts, according to the Colorado-based National Ski Areas Assn. There are 490 ski areas nationwide, 31 of those in California.

On a recent Sunday at Mammoth Mountain, Mammoth Hospital's seven-bed emergency room treated about 100 patients, says hospital spokeswoman Lori Ciccarelli. "We don't have army cots, but on the weekends during the winter, gurneys are lined up in the hallway," she says. Mountain High in Wrightwood has different challenges delivering emergency medical treatment--the nearest hospital is at least 40 minutes away, and many injuries are treated at the first aid station on site.

While few ski areas release individual injury statistics or the annual number of accidents on their mountains, the national ski association reports that an average of 34 people are critically injured on American slopes each year. The number was higher in the 2000-2001 season, when 33 skiers and 11 snowboarders were seriously hurt.

"Nationally, we had a record season last year," says Stacy Stoutenberg of the ski association. "There are just more people out there skiing."

Locally, Snow Summit president Richard Kun says that it is actually getting safer out there--at least on his slopes.